Factors Associated with Survival in Patients of Enteric Perforations; A Retrospective Analysis of 73 Patients

Abstract

Objective: A retrospective study was conducted with 73 patients of enteric ileal perforation to determine the factors influencing survival.
Method: A 2 years retrospective analysis from March 2008 to March 2010 was carried out at South Surgical Unit of Mayo Hospital, Lahore (Pakistan) from admission and operation records taking into account multiple factors associated with sur-vival in patients of enteric ileal perforation.
Results: A total of 73 patients presenting over two years in South Surgical Unit of Mayo Hospital were included in the study. An overall mortality rate of 10.96% was observed. Most common predictive factors for the mortality were perforations > 0.5 cm (15.9%, p 0.135*), peritoneal fluid recovered at laparotomy > 1,000 ml (13.3%, p 0.702*), with most significant factors being > 2 weeks pre-hospital symptoms of perforation (53.8%, p < 0.01*) and development of post-operative septi-cemia (80%, p <0.01*).
Conclusion: Mortality rates from enteric perforations are still high in developing countries. Females are more prone with size of perforation > 0.5 cm, > 1,000 ml of peritoneal fluid (p-values > 0.05 for each), pre-hospital symptoms of perforation > 2 weeks (p-values < 0.05) and development of septicemia (p-values < 0.05). Most of deaths occur within first week of admission.
Key Words: Enteric Perforations, Ileal Perforations, Septicemia.